Pharmacists to 'cut care home medicines'

NHS England is planning to fund the recruitment of 240 pharmacists and pharmacy technicians to work in care homes to try to cut down on unnecessary medicines taken by the residents.

Care home residents often have one or more long-term health conditions, with some prescribed 10 or more medicines.

Trials have shown that pharmacists reviewing medicines reduced their use and improved patients’ quality of life.

In one trial, an annual drug cost saving of £249 per patient was seen.

That pilot scheme took place in East and North Hertfordshire across 37 care homes.

Altering doses

Eleesha Pentiah, a pharmacist in Letchworth, bases herself in a care home for the day and goes through all the medicines taken by residents, addressing any issues.

“I had an 85-year-old man who was on co-codamol after surgery, but that made him feel fuzzy so we put him on regular paracetamol instead, which was much better,” she says.

Sometimes it’s as simple as altering doses of medication, taking into account lowering blood pressure as people get older and more frail.

“Before, they might have been on a list to see the GP – but they don’t always have enough time to analyse it all.”

Eleesha says it has also stopped residents from ending up in hospital.

Studies suggest that up to one in 12 of all hospital admissions of residents is medicine-related and two-thirds of these are preventable.

Trials across six care home sites:

reduced reported emergency hospital admissions by 21%

reduced oral nutritional support usage by 7%

reduced ambulance callout by up to 30%

made drug cost savings of between £125 and £305 per resident

The introduction of these specialists is part of NHS England’s Refreshing NHS Plans for 2018-19 scheme, which sets out measures to provide joined-up services for patients to ensure they receive the most appropriate care.

‘Bang on target’

Simon Stevens, chief executive of NHS England, said: “There’s increasing evidence that our parents and their friends – a whole generation of people in their 70s, 80s and 90s – are being overmedicated in care homes with bad results.

“The policy of ‘a pill for every ill’ is often causing frail older people more health problems than it’s solving.”

Sandra Gidley, who chairs the Royal Pharmaceutical Society, told the BBC: “Our overstretched NHS is crying out for solutions and this one is bang on target.

“This is a great start towards improving the care of residents by making the most of the skills that pharmacists have to offer.

“We’d like to encourage NHS England to go even further and give pharmacists overall responsibility for medicines and their use in care homes.

“Around £24m of medicines is wasted every year in care homes and pharmacists can set up systems that improve efficiency whilst at the same time providing better health outcomes.”

The roles for 180 pharmacists and 60 pharmacy technicians are being funded over two years at a cost of £20m by the NHS England Pharmacy Integration Fund.

They will be recruited from April, with people starting to take up posts in the summer.

The successful candidates will not be based in individual care homes but will be deployed by the hospital trusts to work wherever needed.

There are currently 45,923 registered pharmacists in England, 19,510 registered pharmacy technicians and 12,042 community pharmacies.

Ms Gidley said: “Having a pharmacist available to provide regular medicine reviews will help residents stop, reduce, or upgrade their medicines to improve their health and quality of life.

“Better use of medicines also improves residents’ safety by reducing the number of falls they have, which are another cause of hospital admissions, and incurring an estimated annual saving of approximately £135m.

“So the saving is great but the improved quality of life is even more desirable.”